In recent decades, degenerative diseases affecting articular cartilage, such as osteoarthritis, have become increasingly common, compromising the quality of life of a growing number of patients. Scientists have studied many techniques to limit joint pain and to attempt to repair damaged tissue, but none has reported convincing long-term results. A breakthrough came with the discovery of tissue engineering, which proposed new therapies using autologous cells, such as chondrocytes and stem cells. Much research has been done to try to improve in vitro culture, with many strides being made in the development of scaffolds, bioreactors and stimuli that improve the stem cell differentiation, such as growth factors and mechanical stresses. Recent studies have focused on the efficacy of mesenchymal stem cells (MSCs) derived from adipose tissue or bone marrow as a therapy for cartilage regeneration, reporting that the nature of the repaired tissue is hyaline-like resulting in improved quality of life for patients. Despite this, there are still few clinical trials performed with medium-term follow-up and further studies needed to verify their long-term efficacy and safety.
Negli ultimi decenni, le malattie degenerative che colpiscono la cartilagine articolare, come l’osteoartrite, sono diventate sempre più frequenti compromettendo la qualità di vita di un crescente numero di pazienti. Si sono studiate molte tecniche per limitare il dolore all’articolazione e per cercare di riparare il tessuto danneggiato, ma nessuna di queste ha riportato risultati convincenti a lungo termine. Una svolta si è ottenuta con l’avvento dell’ingegneria tissutale che ha proposto nuove terapie attraverso l’utilizzo di cellule autologhe, come condrociti e cellule staminali. Molte ricerche sono state effettuate per cercare di migliorare la coltura in vitro, con molti passi in avanti nello sviluppo di scaffold, bioreattori e stimoli che migliorino la differenziazione delle cellule staminali, come fattori di crescita e sollecitazioni meccaniche. Recenti studi si sono soffermati sull’efficacia delle cellule staminali mesenchimali (MSC) derivate dal tessuto adiposo o dal midollo osseo, come terapia per la rigenerazione della cartilagine, riportando che la natura del tessuto riparato è ialino-simile con conseguente miglioramento della qualità di vita dei pazienti. Nonostante ciò, gli studi clinici effettuati sono ancora pochi e con un follow-up a medio termine; pertanto, sono necessari ulteriori studi con follow up estesi per verificare la loro efficacia e sicurezza a lungo termine.
L’ingegneria tissutale nella rigenerazione della cartilagine articolare
MERLIN, LORENZO
2022/2023
Abstract
In recent decades, degenerative diseases affecting articular cartilage, such as osteoarthritis, have become increasingly common, compromising the quality of life of a growing number of patients. Scientists have studied many techniques to limit joint pain and to attempt to repair damaged tissue, but none has reported convincing long-term results. A breakthrough came with the discovery of tissue engineering, which proposed new therapies using autologous cells, such as chondrocytes and stem cells. Much research has been done to try to improve in vitro culture, with many strides being made in the development of scaffolds, bioreactors and stimuli that improve the stem cell differentiation, such as growth factors and mechanical stresses. Recent studies have focused on the efficacy of mesenchymal stem cells (MSCs) derived from adipose tissue or bone marrow as a therapy for cartilage regeneration, reporting that the nature of the repaired tissue is hyaline-like resulting in improved quality of life for patients. Despite this, there are still few clinical trials performed with medium-term follow-up and further studies needed to verify their long-term efficacy and safety.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/44033